Researchers at St Joseph Mercy Hospital in the United States found that an at-home neutralizing monoclonal antibody (MAB) infusion program was effective in preventing hospitalization among patients with SARS-CoV-2 infection at increased risk for progression to severe disease. These findings were published in JAMA Network Open.
Between February and May of 2021, a team of 3 nurses reviewed data captured from patients who recently tested positive for SARS-CoV-2 infection on polymerase chain reacting testing to assess their eligibility for MAB therapy. The team of nurses contacted patients to obtain consent for receiving a MAB infusion in their home. In addition, clinical and demographic information was abstracted from patients’ electronic health records, and health outcomes were assessed during a follow-up period of 14 days.
Among a total of 144 patients who received an at-home MAB infusion, 57.6% were women, the mean age was 60.1 (standard deviation [SD], 14.2) years, 86.8% were White, and 23.6% were covered by Medicare. In regard to comorbid conditions, 8 (5.6%) patients had chronic kidney disease, 35 (24.3%) had diabetes, 12 (8.3%) were either immunosuppressed or receiving immunosuppressive therapy, 63 (43.8%) had either cardiovascular disease or hypertension, and 22 (15.3%) had chronic obstructive pulmonary disease. Of note, 20 patients (13.9%) resided in households where multiple members received MAB infusions.
Hospitalization due to worsening COVID-19 symptoms after MAB infusion occurred among 8 (5.6%) patients. These patients remained hospitalized for a mean of 3.3 (SD, 2.2) days, during which time none required intubation. Of 2 patients who developed hypersensitivity reactions following MAB infusion, 1 was admitted to the hospital and 1 was evaluated in the emergency department without subsequent hospital admission.
This study was limited by its inability to track the total number of patients eligible for at-home MAB therapy, as well as the outcomes of those who refused treatment.
“At a time when physical and health care worker resources were significantly strained, our real-world approach leveraged the ability of nurses to identify, triage, and coordinate home MAB infusions while successfully preventing high-risk patients [with SARS-CoV-2 infection] from progression to severe disease and hospitalization,” the researchers concluded.
Malani AN, LaVasseur B, Fair J, et al. Administration of monoclonal antibody for COVID-19 in patient homes. JAMA Netw Open. 2021;4(10):e2129388. doi:10.1001/jamanetworkopen.2021.29388